Grief and bereavement
Grief is a term that describes all the feelings, thoughts and behaviour that someone goes through after bereavement.
Grief is a multi-stage process that can become "locked" in any of the stages. EMDR is particularly effective in terms of allowing the processing to continue. In such circumstances, especially if trauma is involved, talking therapies may not result in closure.
Bereavement can serve to revive old memories / conflicts. When we experience grief we are generally mentally looking backwards in time and perhaps remembering past negative experiences or lost opportunities. This is one of the key strategies that drives depression hence there is considerable debate in terms of whether grief is depression or not.
There is active debate in terms of when to intervene. One could take action within a few months or allow the process to continue without intervention perhaps for several years. The deciding factor is in terms of how the grief is affecting the person's daily life. Only the person suffering from grief can make the decision in terms of when to take action.
One should note that sedatives, anti-depressants and alcohol can extend the processing timeline, and can lead to addiction to mask unresolved issues.
Exercise is helpful for many: Walks in the High Wycombe area
What is bereavement?
This is a term that can be used to describe any event that includes loss, so this could mean losing your job or the death of someone you know or the loss of a relationship eg through divorce or separation. Grief can even be experienced when a treasured mobile phone is lost.
Debate still continues as to what normal grief consists of and whether it is distinct from depression. It is very common for people to have symptoms that are often used to diagnose depression after bereavement. It is less common for people to experience a depressive illness and require treatment for this.
What is normal grief?
This is a term used to describe the typical symptoms somebody experiences after bereavement. It can include:
- disbelief, shock, numbness and feelings of unreality
- feelings of guilt
- sadness and tearfulness
- preoccupation with whatever has been lost
- disturbed sleep and appetite and, occasionally, weight loss
- seeing or hearing the voice of the person lost
The initial disturbance the above symptoms causes is gradually reduced and people begin to accept the loss and readjust.
A grief reaction can last for up to 12 months, but can vary within different cultures. The average is probably around six months.
What is abnormal grief?
This is a term used to describe a grief reaction that is somehow different. It is usually used when grief is very intense, prolonged or the reaction is delayed. It also is used if the symptoms experienced are outside the normal range. Parkes felt these symptoms included:
- preoccupation with feelings of worthlessness
- a belief that the unwanted feelings will never pass
- excessive guilt
- marked slowing of thoughts and movements
- a prolonged period of not being able to function as well
How common is depression after bereavement?
There isn't a straightforward answer to this. The results from studies vary. A study by Zisook in 1993 looked at the rate of depression in late-life widows. The results showed that 16% of them had depression 13 months after bereavement.
The symptoms of depression associated with grief are the same as those for depression occurring at anytime.
Who is likely to get depression?
It is difficult to judge who will or won't suffer depression after a bereavement. However, risk factors thought to increase the chance include the following:
- a previous history of depression
- intense grief or depressive symptoms early in the grief reaction
- few social supports
- little experience of death
Diagnostic and statistical manual criteria (DSM)